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Liquid. But what you are wanting is a diet...not just liquids. Grapefruit juice w/ green Beans and broiled chicken...that's what alot of people use to get weight off...QUICK. I wouldn't worry about the weight gain a bit. So what you gained 6 pounds during your grandmother's passing. That's not going to stop a doc from doing surgery.

Kellie, what stage of your diet are you on if you had surgery on July 9th? Did I read it wrong? Are you only 11 days out? I was only starting full liquids at 11 days and was on that for 5 weeks. I am still on soft foods until Sunday and I know it's going to be a while until I can actually go to regular foods. I'll be 7 weeks out on Monday and yesterday I had a Protein shake for Breakfast, I had one piece of deli light ham chopped into 3 teaspoons of cottage cheese for lunch, and for dinner I ate about about an 1.25 ounce of turkey tenderloin, 4 baby cooked carrots, about a teaspoon of 1% cottage cheese, and about a teaspoon of instant mashed potatoes. I spent an hour uncomfortable and realized I should have foregone at least one cooked carrots. My entire day I had less than 485 calories, 33 grams of carbohydrates (which is higher for me), 6 grams of fat, 60 grams of protein. You had one bean burrito from Taco Bell for dinner. 370 calories, 56 grams of carbohydrates, 11 grams of fat,13 grams of protein. While newly sleeved until maintenance most doctors ask that you stay within 40-45 grams of carbs per day. I'm sure it went down easy because the shell, the Beans and whatever is in it is just food that can easily be chewed up and swallowed and if you drank anything at all with that, it is just going to slide down your tummy, preventing the full feeling you were suppose to have. I know it's a lot less than you used to eat, but it's not a wise choice and truthfully that's the food that causes people to gain weight in the first place. High carb makes you hungrier. Add what you ate for the entire day and you will see. Are you charting your food, Water etc. on anything like myfitnesspal.com? I just would hate to see someone go through this surgery and wonder why they aren't losing weight or even gaining weight or go back to their bad habits. I would really hate to see you end up with a leak, eating solid foods immediately. I can't imagine your doctor would allow soft or solid food food at 11 days post-op. You may very well lose weight while eating like this at first, because you are only 11 days out and will be losing water etc. first, but you will struggle losing fat because you will be taking in too many carbohydrates and once that is used for fuel it will be restored as fat. Your stomach isn't even healed yet, and you are pushing the limits of it's size already. If you haven't been told where you are suppose to be nutrition wise, I would definitely speak with your nutritionist or find one, because I think you really need to talk to someone. Many people seek support from a behaviorist or therapist, to try to get to the underlying reason for the weight gain in the first place. I think it's wonderful that you see such an improvement but at 7 weeks, I could not eat even a bite or two of that, and it worries me that you don't see that was a bad choice for a meal. I hope you take this post in the light I am intending, as someone who has done a lot of research on the sleeve and started out the six month pre-approval phase working on behavior modification, lowering my carb intake and really fully getting to the root of my eating problems to begin with. Good luck to you and I wish you the best.

Other results from the doc concluded that I was hyperthyroid. Actually I already knew this and I've been that way for about ten years, although when I went down to Mexico to get my sleeve it showed normal -- I was severely depressed at the time, understandably. K so now I have a Real Job and that means I have a real GP which means I got my physical and bloods taken. High thyroid, low Iron, low white count, low neosophils or whatever they're called. These are the drugs she wants me to take: Metaprolol Doxepin I do not want these drugs. One is a tricyclic that causes weight gain. One is a beta blocker that causes weight gain. I weigh 200.5 today. I am SO CLOSE to Onederland and no way in hell am I taking some concoction that is going to put thirty pounds on me by next week. I do want more energy, I want to sleep better, I want to not obsess and have panic attacks, which is what these things are supposed to be for. But I'm 36 pounds from goal! Help me Obi Wan. Anybody else have either of these, are you doing herbal remedies, other options....anything?

:girl_hug: I 'm not banded yet and have many questions. Some people who have had gastric bypass do not change their eating. They strech out their pouch, and regain their weight. Is this possible with a lap band? I know that if it is removed there is danger of weight gain, but is it possible to gain weight with a band?

It may be because my weight gain was mostly medication- induced and then due to lack of movement from the pain I was in?? There wasn't a weight issue prior to my getting sick. Who knows? I know most plastics guys want you stable for at least 6 months. Another surgeon I wanted to consult with won't even SEE me until I hit my target weight. Not even to consult for costs. Either way, I would not consider doing anything yet. First- the cost-need to save for it; Second- I DO want to be at goal. Fortunately, the weight continues to come off without stalls, albeit a little slower now. 2lbs drop since day before yesterday! Lol. LOVE this tool!! More? Love having gotten my life back and all of the opportunities and changes it has effected for me! Did you end up having the plastics yet? Sent from my iPhone using the BariatricPal App

I am so confused about all the insurance stuff - and I know that this isn't the best place to get specific help, but I'm hoping that it can just be made clearer for me. I'm not American - I'm from the UK and we have universal healthcare, so the insurance thing has always confused the feck out of me! I live in upstate NY, my husband works for the State and therefore has very good insurance. It covered our IVF and my breast reduction surgery 100%, for example. It's United Healthcare - but is also apparently the NYS Empire Plan. But it is Blue Cross Blue Shield if there is a hospital stay involved?? Anyway - I went to my primary care doctor. She has the same problems as me (PCOS - an endocrine issue, one of the main symptoms of which is weight gain with the inability to lose, and ultra low metabolism). She has had weight loss surgery herself, and so was quick to recommend it. She gave me the name of a surgeon, but didn't give me referral letter. I signed up as a new patient on his website, completed the mandatory seminar, and set up an initial consult. I went for the consult last Thursday (06/07/18) and they weighed me and took a history. The nurse said my insurance requires 6 months of weigh ins, which have to be done every 28-30 days. This threw a spanner in the works, because I go home to the UK for the summer, leaving early July. Because I am not back until the middle of August, I was told that I would have to start in September - I wanted to come in August, but was told that it had to be in September because it goes in 4 weekly blocks. Maybe she meant from the date of the consult? So they said I would have to see the nutritionist, have an endoscopy, a psych eval, an EKG, a colonoscopy. I pretty much expected that as I had looked up our insurance plan's rules for surgery: https://www.empireblue.com/medicalpolicies/policies/mp_pw_a053317.htm I am right at 36 BMI and the policy for BMI with co-morbidity (I have PCOS, diabetes, high cholesterol) is 35. I was not told to lose weight - but what will happen if I fall under 35 while doing the weigh ins? Also, they said that after the 6 weigh ins and other procedures, they forward it to the insurance. Does that mean that it could still be denied? Am I essentially doing this blind right now? I read about people hear calling their insurance - am I supposed to be doing that? Do I need to get prior authorisation for this, or is the weight loss centre supposed to deal with it? Again, I'm sorry if Im being really dumb - I just want to understand the process.

Hi, I'm 26 years old and 23 weeks pregnant with my first child, a girl, Sofia :thumbup: 'm due March 9th 2011 I was banded in 2006 it slipped in late 2007. I started at 233 pounds and got down to 140 pounds. I had the band put back in 10 months later in 2008. and was weighing about 185lbs, and since got done to 135lbs. I admit the first time around i was throwing up excessively and not following eating rules. This time of around i have been really careful, in very slowly filled my band. I threw up rarely like maybe 1-2 times a month twice but it was never a violent vomitting episode. More like the food was stuck in my throat and i could make myslef productive burp enough to throw that last bite out. Early this year at my last fluoro doctors were concerned about the positioning of my band and told me to be careful and stick to the rules. They think since it slipped once i might just be more prone and with the weight loss my organs shifting around such has caused my band to move. In june at my regular docs recommendation i loosened my band and put on 10lbs i was having fainting issues and some nutritional defeciences. So i went up to 145lbs within a month and found out i was pregnant in July In September i began having horrible acid reflux at night which had experienced previously when my band was too tight so back i went to the doc and he removed everything but 1 cc, i have the largest band. I do have some relief and take nexium and pop antacids like crazy. the reflux is really horrible, when the acid rises to my my mouth it makes me gag and then i throw up.. BAD! i am so terrified my band is gonna slip again. I dont wanna put my baby at risk, if heaven forbid emergency surgery was required. I know what it feels like it when its slipped and so far its okay i can eat plenty which is great but i am terrifed. I vowed after 3 days of throwing up stomach acid, that i was going to on liquids for 2 or 3 days until the pain in my throat/stoma settles done...and really stick to a structured diet...BLAND food, no eating after 6pm just to play it safe. no spicy food, chocolate, carbonation, etc at this point i think i am going to remove the band some time next fall, i really dont think i can deal with another pregnancy with acid reflux and the anxiety that comes with thinking i might be harming the baby. So my two main concerns and questions for other banded pregnant mommies out there 1. how are you coping with the reflux? 2. How much weight had you gained at 23 weeks? I'm really afraid i am not eating enough for the baby, i am not showing yet, and at my last ultrasound the baby was measured to be at 20wks instead at 21weeks. Presently i'm 152lbs after 3 days of no food intake prior to that i was 156 lbs and really happy with the weight gain. starting weight at beg of pregnancy 145lbs now 152-156lbs thanks :wink5:

Hi everyone. I am 5 weeks out of sleeve surgery and have stopped losing weight. Total loss so far is 14 lbs. and the weight gained in past week is 1 lb. I am soo worried..what am I doing wrong. Can anyone spare me a few minutes please Sent from my iPad using the BariatricPal App

I wonder if having this type of surgery also affects the thyroid gland. One of the symptoms (major symptom for me before I was diagnosed with hypothyroidism in 1995) of hypothyroidism is hair loss, and for me it was by the clumps! Other symptoms include being cold, weight gain, and lethargy. I had all of those, as well. Apparently there are many people out there who have hypothyroidism who don't know they have it, as the symptoms creep up slowly, and sometimes there are no symptoms at all. A simple blood test at your doctor's office will tell you if you have it. I take a tiny pill every morning that takes care of my symptoms. Worth looking into if you think you may have it. I wonder if having hypothyroidism and having the sleeve surgery may enhance hair loss. I will be asking my GP when I see her in February. I'll also ask my surgeon (if I ever see him again!). Good luck all!

Holding on.. fine. But I have never heard of eating to little causing WEIGHT GAIN( Unless a medical issue obviously) She remembered her crackers later on. I'm sure we have all digested something and forgot about it.. I'm not saying op is not telling the truth but if she goes to her doctors and finds nothing medically wrong. Just how she forgot to mention her bag of crackers. Is just how she could be forgetting something else. If that makes sense ? Sent from my Vivo 5R using BariatricPal mobile app

I spent most of my life thin. I was a thin and active kid, thin through my 20s and early 30s and then BAM! my metabolism slowed to a virtual standstill and I gained weight effortlessly. I had it tested several times - if I ate > 800 cal a day I'd gain weight. I had test upon test to see why and nothing came back abnormal. I never ate much, rarely cleaned my plate. Not a big fan of sweets (only on special occasions), not a snacker - I could walk by the office candy bowl and not even think about it. Don't like Cheetoes. If I ate fast food, it was maybe once a month and then it would be a Happy Meal. People would assume I was a closet eater, but I wasn't. Didn't drink sugary soda or beverages. My SO and I could eat the exact same thing, I'd eat less and STILL gain weight. I ate only because I had to, no to fill some emotional void. I've frequently gone all day without eating just because I wasn't hungry. My point is genetics play a huge role in weight gain. My mother was overweight and didn't eat poorly either. There is nothing that I can look at in my eating habits and say "that's it! That's the problem!l" except eating out, an unfortunate byproduct of my career and lifestyle. With the sleeve that will change (and I'll save a ton of money!). But seriously, genetics do play a huge part in weight - don't discount that.

Truth, that's why I said if she truly gained 20 pounds on the intake she says she has she should see a doctor because that might be an underlying issue or a medication issue if she is taking any medications (some cause weight gain). But having to low an intake can stall you per my NUT and personal experience. Not make you gain for sure, but stall nontheless, so eating to little is not going to help the situation either. If she really is eating what she says she is.

To Honk and the others, no I don't think you are being mean spirited... I know you mean well and I appreciate your honesty. I will call my doctor's office today and let them know I honestly don't think I can do "all liquids" for the next 2 weeks and 5 or so days. Everytime I try, I fail. No one in my family feels I can do it either and they feel I shouldn't get the surgery at all. If I don't loose the weight I won't be getting the surgery. I can't understand how I WAS loosing before they TOLD ME to loose more, as soon as they said that I started gaining. Yes, my portions are big because I stay hungry. I'm on medicine that causes weight gain as well. The other night, I made it all the way up til bedtime, then I ate my grand daughter's chicken nuggets that she didn't want. (I HATE chicken nuggets) but I was so hungry I threw them in my mouth regretting only after I ate them. And Honk you are a inspiration.. you did the liquid diet so many months before surgery - that is amazing. How did you do it? I can't even get a good 1 day in without cheating. I'm going to try again today.

Yes. Your sleeve may have streched. But your having weight gain because your eating too much. Many people can have a bigger sleeve without filling it. I'm not sure if you understand what I'm saying 61lbs and don't eat anything doesn't add up . So if your sleeve stretched you put food in it to stretch it. If you gained 61lbs and have no other health issues were did it come from if you didn't eat ? I'm not judging you but we have to take responsibility or we can't make changes. So if you can be honest to say what you ate to gain 61lbs. Perhaps someone can even help you with food ideas to swap to help you lose again. If you continue to say you eat nothing. When your sleeve has stretched and you gain 61lbs.. then how can someone help ? We all may slip up without noticing. And you may have another surgery but we still have to be mindful or it will stretch again But goodluck anyway Edit sorry I just noticed your not the original poster lol I thought you were replying to me because you were ! Sent from my Vivo 5R using Tapatalk

Hey Georgia Girl. I was an advid jogger as a teenager and twentysomething young woman, but because of my weight gain I stopped. I so want to jog again, but I am afraid because I am 5'6" and 220 pounds. I don't want to stress my joints by jogging/running with this excess weight. However, I know that I can lose the weight quicker if I jog/run rather than walk. Are you running on a treadmill or outdoors. I so want to run/jo outdoors, but I was thinking I would have to loose more weight first.:confused:

Just an FYI when I first inquired to be resleeved I had an endoscopy done to find out what the problem was and my stomach was totally stretched. My doctor shared with me that when I first got the sleeve five years ago they weren’t taking chances and doing the sleeve as tight as they are doing them now and that’s one of the reasons why my stomach stretched and I was having a weight gain

Well I will be banded monday and I have to say I have often wondered myself about the weight gain but my doc said as long as I listened to him and had my band in good working order I will be fine hope this helps

So I am on the "unweightloss" program right now. When I finally was able to see my insurance company's policy regarding weightloss surgery I read in exact terms this: Failure of medical management including evidence of active participation within the last two years in a weight-management program that is supervised either by a physician or a registered dietician for a minimum of six months without significant gaps. This is frustrating to say the least. I WANT TO LOSE WEIGHT. I WANT TO LOSE WEIGHT NOW. AND I WANT TO LOSE WEIGHT FOR GOOD. I am seriously struggling with this. In fact, with just changing my diet and not even my exercise levels, I seem to have misplaced TEN pounds over the past four days! I knew it was coming. My weight issues have always revolved around my hormone inbalances created by being a wonderful glorious woman (said dripping with sarcasm). Once a month - lasting for about a week - no matter what I do, I can't lose a single ounce. Once a month - lasting for about three days - no matter what I do, I gain five to seven pounds. And for the rest of the month, the weight melts off of me when I am behaving. Before I really discovered the trends and understood my body, this would get frustrating beyond all get out. But it's not so frustrating anymore. Now I can muscle down and just keep doing what I'm doing and know that when my hormones balance back out, I will be down. I have said before that my weight gains have always come when I get off of birth control. It's that hormone fluctuation that makes my body go crazy. So I'm off birth control, I'm regular, and I'm "normal", too. HA! I knew, because of where I am in my cycle, that I'd see a drop this week. I WAS NOT EXPECTING THAT DROP TO BE TEN FRIGGIN POUNDS! That TEN pounds puts my BMI below 40 - therefore making me ineligible. So...I have to gain it back. Yes, you heard me. I have to gain it back. I really have no choice. Unless I forego this and say "I can do this by myself". I have no doubt that "I can do this by myself". I do doubt that I can keep it off by myself. Which is why I'm here. I WANT TO LOSE WEIGHT. I WANT TO LOSE WEIGHT NOW. AND I WANT TO LOSE WEIGHT FOR GOOD. Sigh. I don't want to gain it back. I DON WANNA! THIS IS SO STUPID! :thumbup:

Thanks Jenny! Through all three pregnancies and even this weight gain, I always maintained great blood pressure...not once was it ever high. However, when I went to the gym to speak to a personal trainer, they did an assessment. She informed me that my blood pressure was considered high. I have recently (within the past 4 months) started getting migraines and panic attacks...something I have NEVER had before (and you are talking to someone who took care of 3 children all by herself AND worked fulltime!). But other than that, no other health problems. Both of my parents were diabetic (only my mother was obese) and both had one form of cancer or another. I dont want to ever be in that boat, you know? I am calling my doctor tomorrow to schedule a checkup with him. I have always found him to be supportive but I wonder why he has never approached the subject about my weight. Living in denial is NOT fun especially when the reality sets in.:faint:

You are not alone in the weight gain Makemelean, lots of us gained over the holidays, do not beat yourself up over it. You will not have much restriction until you have your first fill. No you are not alone lots of us have gone through the same thing, and you will be okay, just hang in there, let us know what the surgeon has to say, and please do not think of yourself as a failure. :hug: Good luck Maria

Well I recieved a call from carters office and was told they were wrong about the sleeve, aetna believes it is dangerous and too new so they don't cover it. Sucks for me because I am not looking forward to getting the band, I mEan I will be content and do everything I can with it but really hoping for the sleeve. But like you said, it has to be a psycological thing withthe weight gain because I cannot diet nor get to the gym, every time I try i cannot stay on it and I too eat like it is my last meal. If you don't mind can you let me know the cash price for the surgery, you can send in pm if you like but I wonder because dr Carter charges 12,000 for th sleeve and I don't want to pay that much. Good luck and please keep us all informed on your surgery and be safe!

I have had both Inamed LapBands. The VG 10cc band is usually filled to 3-5cc's at the time of surgery. I presently have 9.5 cc's in my VG and only PB occasionally when I try to eat steak which just doesn't work or am stressed while eating. Are you sure that you have a 10cc band and the 4cc?? Many people get confused with the length of their band and not the fill capacity. If you can't eat and it hurts no matter what band you have I recommend that you get some saline removed before you get side effects like reflux or soft food syndrome which will lead to poor eating choices and a weight gain. My surgeon will fill me beyond capacity but I am doing it the old fashioned way to get off the last 20 pounds and still be able to eat a variety of foods in different parts of the globe. BTW, I can wear size 8 jeans (J. Jill "Tried and True Fit") which are loose at the waist now. I may just stay where I am and just maintain this weight. Each surgeon seems to do fills very differently and each of our bodies react differently to fill levels. That being said, if you are in pain and it hurts when you eat time, it is time to contact your surgeon to discuss the situation. Being too tight leads to a prolapse (slipped band) which often has to be replaced. I hope that my "wisdom" of being band for 3 years with the 4cc band for 14 months and the VG band for 25 months helps you.

and more............ http://mcgs.bcbsfl.com/ THIS MEDICAL COVERAGE GUIDELINE IS NOT AN AUTHORIZATION, CERTIFICATION, EXPLANATION OF BENEFITS, OR A GUARANTEE OF PAYMENT, NOR DOES IT SUBSTITUTE FOR OR CONSTITUTE MEDICAL ADVICE. ALL MEDICAL DECISIONS ARE SOLELY THE RESPONSIBILITY OF THE PATIENT AND PHYSICIAN. BENEFITS ARE DETERMINED BY THE GROUP CONTRACT, MEMBER BENEFIT BOOKLET, AND/OR INDIVIDUAL SUBSCRIBER CERTIFICATE IN EFFECT AT THE TIME SERVICES WERE RENDERED. THIS MEDICAL COVERAGE GUIDELINE APPLIES TO ALL LINES OF BUSINESS UNLESS OTHERWISE NOTED IN THE PROGRAM EXCEPTIONS SECTION. Non-Covered Billing/Coding Reimbursement Program Exceptions Definitions Related Guidelines Other References Updates DESCRIPTION: In cases where a severe, potentially life threatening condition develops which is documented in the medical record, gastric bypass revision is considered medically necessary and may be eligible for coverage. WHEN SERVICES ARE COVERED: The following lists examples of conditions AND/OR diagnoses for which gastric bypass revisions may be covered: <LI class=bulletedList-1>Weight loss of 20% or more below the ideal body weight (based on the 1996 Metropolitan Life Height & Weight tables Men and Women) <LI class=bulletedList-1>Esophagitis (e.g., esophageal reflux) <LI class=bulletedList-1>Hemorrhage or hematoma complicating a procedure <LI class=bulletedList-1>Vomiting (bilious) following gastrointestinal surgery <LI class=bulletedList-1>Gastrointestinal complications, (i.e., complications of intestinal (internal) anastomosis and bypass) <LI class=bulletedList-1>Stomal dilatation, documented by endoscopy (not UGI) <LI class=bulletedList-1>Pouch dilation documented by upper gastrointestinal examination or endoscopy, producing weight gain of 20% or more <LI class=bulletedList-1>Stomal stenosis after vertical banding, documented by endoscopy, producing vomiting or weight loss of 20% or more <LI class=bulletedList-1>Other and unspecified post surgical nonabsorption (i.e., hypoglycemia and malnutrition following gastrointestinal surgery) <LI class=bulletedList-1>Other post-operative functional disorders (i.e., diarrhea following gastrointestinal surgery), <LI class=bulletedList-1>Severe dumping syndrome <LI class=bulletedList-1>Post-gastric surgery syndromes (i.e., post-gastrectomy syndrome, post-vagotomy syndrome) <LI class=bulletedList-1>Disruption of operation wound <LI class=bulletedList-1>Staple line failure, documented by upper gastrointestinal examination Disrupted staple line provided there has been prior weight loss. WHEN SERVICES ARE NOT COVERED: Gastric bypass revision services are not covered when coverage criteria are not met as described in the WHEN SERVICES ARE COVERED section or when the member's contract does not provide benefits for these services. BILLING/CODING INFORMATION: CPT Coding: 43848 Revision , open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric band (separate procedure) 43850 Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; without vagotomy 43855 Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; with vagotomy 43860 Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy 43865 Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy 43886 Gastric restrictive procedure, open; revision of subcutaneous port component only 43887 Gastric restrictive procedure, open; removal of subcutaneous port component only 43888 Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only ICD-9 Diagnoses Codes That Support Medical Necessity: 530.1 Esophagitis (esophageal reflux) 536.1 Acute dilatation of stomach (documented by endoscopy, not UGI) 536.1 Pouch dilation (documented by UGI or endoscopy; producing weight gain of 20% or more) 537.6 Stenosis of stomach (after vertical banding documented by endoscopy; producing vomiting or weight loss of 20% or more) 564.2 Postgastric surgery syndrome (i.e., post-gastrectomy syndrome, post-vagotomy syndrome, severe dumping syndrome) 564.3 Vomiting following gastrointestinal surgery 564.4 Other post-operative functional disorders (i.e., diarrhea following gastrointestinal surgery) 579.3 Other and unspecified postsurgical nonabsorption (i.e., hypoglycemia, malnutrition following gastrointestinal surgery) 783.2 Abnormal loss of weight (20% or more below the ideal body weight according to the 1996 Metropolitan Life Height & Weight tables for men and women) 997.4 Digestive system complications (i.e., complications of intestinal (internal) anastomosis and bypass) 998.11-998.13 Hemorrhage or hematoma complicating a procedure 998.3 Disruption of operation wound (i.e., dehiscence; rupture; staple line failure documented by upper gastrointestinal examination; disrupted staple line, provided there has been prior weight loss) REIMBURSEMENT INFORMATION: Refer to section entitled WHEN SERVICES ARE COVERED. PROGRAM EXCEPTIONS: Federal Employee Program (FEP): Follow FEP guidelines. State Account Organization (SAO): Follow SAO guidelines. DEFINITIONS: No guideline specific definitions apply. RELATED GUIDELINES: Surgery for Clinically Severe Obesity (Bariatric Surgery; Gastric Bypass Surgery), 02-40000-10 OTHER: To view the Metropolitan Life Height & Weight tables Men and Women, see Surgery for Clinically Severe Obesity (Gastric Bypass), 02-4000-10. REFERENCES: <LI value=1>American Medical Association CPT (current edition) <LI value=2>Florida Medicare Part B Local Medical Review Policy # 11920: Cosmetic/Reconstructive Surgery (01/01/02, retired 02/01/04) <LI value=3>Florida Medicare Part B Local Medical Review Policy # 40000: Digestive System (01/01/02) <LI value=4>Medical Practice and Coverage Committee (BCBSF) St. Anthony’s ICD-9-CM Code Book (current edition) COMMITTEE APPROVAL: This Medical Coverage Guideline (MCG) was approved by the BCBSF Medical Policy & Coverage Committee on 09/23/04. GUIDELINE UPDATE INFORMATION: 10/15/99 New Medical Coverage Guideline. 01/01/02 Coding changes. 12/15/02 Reviewed; typographical corrections. 10/15/04 Scheduled review; no change in coverage statement; added 43848. 01/01/06 Annual HCPCS coding update (revise 43848; add 43886, 43887, and 43888. Private Property of Blue Cross and Blue Shield of Florida. This medical coverage guideline is Copyright 2006, Blue Cross and Blue Shield of Florida (BCBSF). All Rights Reserved. You may not copy or use this document or disclose its contents without the express written permission of BCBSF. The medical codes referenced in this document may be proprietary and owned by others. BCBSF makes no claim of ownership of such codes. Our use of such codes in this document is for explanation and guidance and should not be construed as a license for their use by you. Before utilizing the codes, please be sure that to the extent required, you have secured any appropriate licenses for such use. Current Procedural Terminology (CPT) is copyright 2006 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. CPT® is a trademark of the American Medical Association. Internet Privacy Statement | Terms of Use © 2006 Blue Cross and Blue Shield of Florida, Inc. Date Printed: January 5, 2007: 10:48 PM

Cheryl Ann Borne hit a high weight of 285 pounds, and got the gastric bypass surgery in 2003. She maintained her weight loss, but the extra skin didn’t go away on its own. In 2013 she began a series of plastic surgeries including a tummy tuck, total body contouring, and facial surgery, and is now a size 2. Cheryl is an obesity health activist who writes as My Bariatric Life on Health Central and PM360 Online. She recently launched her new site, My Bariatric Life, and you can follow her on social media, including on Twitter @MyBariatricLife and on Google+. Weight Gain, Gastric Bypass Surgery, and Lasting Weight Loss Cheryl was an active teen, but she went from “fit to fat” as she turned to processed food. At 5’7”, she got up to a weight of 285 pounds and a size 24W. Cheryl got the gastric bypass surgery in 2003. She had diabetes, celiac disease, depression, acid reflux, asthma, and hypertension. She lost over 100 pounds, managed to get off of 9 of her 10 prescription drugs, and does not have chronic back pain anymore. You can see before and after pictures documenting her transformation by watching this video. A Typical Day in Cheryl’s Life As proof that you can follow a diet without red meat and stick to a high-protein weight loss surgery diet, here is a sample day’s diet in Cheryl’s life. The following day has 1,789 calories, 165 grams of protein, and 79 grams of carbohydrates. Breakfast 2-egg omelet with homemade creamed spinach (dairy-free) and turkey bacon Snack Coffee with coconut milk, roasted coconut juice, and egg white protein powder Mineral water Vitamins/supplements Scivation Xtend intraworkout drink with branched chain amino acids Lunch Tuna salad Baby spring mix and grape tomatoes with lemon vinaigrette Terra Real vegetable chips Dinner Smoked turkey leg, no skin 1 cup turnip greens Snack Egg white protein powder in water Getting Rid of the Traces of Obesity After losing over 100 pounds after the gastric bypass surgery in 2003, Cheryl had a lot of extra skin. In 2006, she met a plastic surgeon whom she really liked. In 2013, she decided to get a tummy tuck. The extra skin hadn’t gone away after weight loss surgery, and she wanted to get rid of it. As she describes below, she was delighted with her surgeon and the results of the tummy tuck, and decided to go further. I went from a size 14 jeans being tight to a perfect size 8 in just 4-months. I was so thrilled with the transformation that I decided to do "all of me." In October 2013, Dr. Joseph F. Capella revised the tummy tuck to a lower body lift, and performed a medial thigh lift, extended arm lift, and breast lift. Dr. Capella removed 11 pounds of skin and one liter of fat, and this enabled me to get active in ways that I was unable to with my hanging pannis and inner thighs that rubbed together. I ran my first 3k with my daughter and granddaughter and eventually I was running 5k. What's more, the muscle plication from the tummy tuck placed renewed constriction on my pouch so I am full with less food, as well, I tightened up on my diet by doing Whole30 [a strict 30-day low-carb diet] and going Paleo. In total, I lost 50 inches and 50 pounds after my body contouring plastic surgery. Today I am a size 2, down from a 24W before my gastric bypass surgery. You can go to HealthCentral to read about Cheryl’s decision to get total body contouring after her tummy tuck. She describes the emotional rollercoaster of the experience, the surgery, and her long road to recovery. She is still dealing with complications from her brachioplasty, but stresses the end goal and her luck in finding a fantastic surgeon who cares about her. She didn’t stop there, and instead decided “to reach for the stars” and see a facial plastic surgeon. In one surgery, Dr. Catherine Winslow took about 15 years off my face, restoring the once pretty face that I had when I was thin. I had a total of 10 procedures: deep plane face lift, neck lift, upper eye lid lift, SMAS (superficial muscular aponeurotic system) to tear troughs and lips, lip lift, chin implant, 35% TCA peel, Botox and filler. I go back from time to time to Nurse Triste at Dr. Winslow's practice for filler and Botox. I look at this maintenance routine along the same vein as maintaining my hair cut and color. Destined to Be a Healer Do you believe in fate? When Cheryl visited Guatemala in May of 2011, a Mayan shaman told her her Mayan symbols showed she was a healer. She could, he said, heal herself and others. As Cheryl tells it below, she wasn’t so sure at first. Then she figured it out. I visited a Mayan Shaman when I was in Guatemala back in May 2011. He said my Mayan symbols told that I am a healer. I can heal myself and I can heal others. He said that I needed to heal others, to not keep this gift to myself, or else I would experience sickness or pain and that this was the only way to cure my chronic back pain, which I had suffered with for years. The Shaman said that I need to realize my true self. The Shaman also said the symbols revealed that I am creative — that I knew for sure, but I wondered was he right about me being a healer? So I tried to heal my beloved mother who was stricken with a rare disease. And I tried to heal my beloved boxer dog, Cindi Lu, who was stricken with an aggressive cancer. But I could not save them and felt that I had failed my destiny. Then in 2012 during a personal development training, I discussed this matter with the instructor. And he replied that maybe I was meant to heal people with my words. I did not give much thought to it after that until one night in 2013, I bolted up from my bed and realized that both the shaman and the instructor were right! Healing with Words Cheryl’s work has exploded. She describes the growth of her writing and advocacy career since finding her voice. I began writing as My Bariatric Life for the HealthCentral Obesity vertical in March 2011, nearly eight years after my gastric bypass. I started out writing just a few articles per month as a health guide -- a patient who would share her real world experience in defeating obesity, diabetes, hypertension, asthma, and GERD. My work grew legs. I now write 18 articles and develop two recipes per month for HealthCentral where I have a following of roughly 75,000 unique monthly readers. I also write a quarterly patient advocacy column for PM360 Magazine under my name, Cheryl Ann Borne, and I am a long-standing member of their editorial advisory board. Cheryl also makes her voice heard by posting as My Bariatric Life on social media, including Flickr, Twitter, Google+, and Pinterest. She is active on BariatricPal and a site for cosmetic procedure patients called RealSelf. Her goal is to provide fair and trustworthy reviews. And this month I will begin writing a monthly opinion piece as My Bariatric Life for BariatricPal. I also am exploring opportunities with the Obesity Action Coalition, and in the past have partnered with Obesity PPM and the Patient Centered Outcomes Research Institute (PCORI). ! Daring Move to a New Career as a Digital Health Strategy Consultant Cheryl has been in the health industry since before her surgery. She explains her career as a digital health strategy consultant. My career has been as a promotions strategist, writer, and designer in the healthcare space with the last 12-yrs in digital marketing. I’ve worked with pharmaceutical and biotech companies and digital health ad agencies and non-CME medical education agencies. I help them to understand the evolving digital health ecosystem and, based on their unique market circumstances, specifically how to communicate with patients and physicians in meaningful ways via digital channels and to ultimately achieve better health outcomes. Cheryl is determined to help people improve their lives. Transforming healthcare is important to me. It's is all about the patient. I want to make a difference; I want to help people live healthier lives. When her company cut her position in 2013, she took a positive approach and decided to focus her energy on fighting obesity. She developed a business plan as a digital health strategy consultant with an emphasis on growing My Bariatric Life, her obesity health activist brand. Paleo Follower and Recipe Developer Cheryl believes in the benefits of the Paleolithic Diet. It is a high-protein diet that you can follow after weight loss surgery. It emphasizes meat, fish, poultry, fruits, vegetables, eggs, nuts, seeds, and oils. It forbids grains, processed foods, dairy products, and potatoes. She plans to help others follow this way of eating. One aspect of my business plan is to launch the brand Borne Appétit in order to teach healthy eating habits and show busy families/couples/singles that it is easy to prepare real food, real simple, and break the cycle of time starvation and over reliance on convenience/processed foods and obesity. To truly understand what it means to eat healthy and break this cycle was something I had to achieve in my own life, and I want to share with people what I have learned through years of experience and experiment. I find the Paleolitihic Diet works best for me…and I enjoy the art of creating delicious recipes within those constraints. I also eat no red meat, only fish and fowl, so this adds an extra level of complexity, which I find stimulating to develop recipes that are not mundane or repetitious. Valuable Life Lessons You can be sure Cheryl has learned a lot of valuable lessons from her weight loss surgery and plastic surgery experiences. She knows the value of maintaining her results, living life fully, and challenging herself to live a life she loves. She also recognizes she has gained freedom and an ability to grow. Beyond the physical transformation are (very unexpected) emotional and spiritual transformations. I’ve returned to some of my roots: ideals and philosophies around the nature of existence that I had walled off (or perhaps ate to insulate myself against) when the emotional pain became too much for my sensitive nature. Plastic surgery was very freeing for me; it freed my jailed spirit. I’ve never been a wallflower but when it came to my body I was timid because I lacked body confidence. And this trickled over into other areas of my life. There were parts of my life that I hid, or situations in which I could not share my feelings, because I was inhibited by the fear of being rejected or judged. And that’s no longer true. I am now able to be my true self, comfortable in my nakedness both physically and emotionally. I am still learning and growing in these areas, particularly in understanding soul relationships and the expression of real love. We are here to play and experience as much as we possibly can. We are here to grow. Often it is through times of adversity that we grow the most because these times force us to get out of our comfort zones. I have come to understand that there are only two emotions. We are either acting out of love or we are acting out of fear, which is the opposite of love. All other emotions are a derivative of love (compassion, forgiveness, self-sacrifice) or a derivative of fear (selfishness, retaliation, deceit). From now on I choose always to act out of love. Do I let go of control and trust my intuition and follow my heart even when it defies my rational faculties or can’t be proven? If I am to act out of love, then yes. Otherwise I return to acting out of fear. As well, I have learned that I need to protect myself from the negative energies of toxic people — those emotional vampires who can turn my love into fear. An Exciting Year to Come Cheryl is expecting a big 2015 in addition to growing her presence as My Bariatric Life and working on Borne Appétit. At the Pharma Marketing Summit in Palm Beach in May, she will be presenting as My Bariatric Life and sharing her story of defeating obesity and its co-morbidities. Also new for this year, I'll finally launch my websites, a dream I've had for a couple of years. I've already launched MyBariatricLife.org for transformative information on defeating obesity and co-morbid diseases. I'll also launch my healthy recipe site BorneAppetit.com and my eating healthy on-the-road travel site BorneVoyage.com. These sites will help a lot of people. It definitely looks as though the Mayan shaman was right when he said Cheryl is a healer. She has come a long way toward healing herself through weight loss surgery, plastic surgery, and healthy living, and she is dedicated to helping others become healthier. Don’t forget to follow Cheryl on social media and through her channel on HealthCentral, and watch for her new monthly opinion piece to be published on BariatricPal! Please click here to read My Bariatric Life's articles in BariatricPal's Weight Loss Surgery Magazine.

A lot of insurance carriers have paid for the revision with out a hitch and others drag their feet. I'm thinking it depends on yours. I was self paid because my insurance doesn't cover wls at all. As for weight gain between band and sleeve.. UGH... I gained 75 lbs, but because of severe complications and damage from lapband I had to wait 18 months to be cleared for sleeve. Good luck!